This study examined the relationship between geographic location and use of mental health services using data collected on 1053 Community Support Program (CSP) clients. Multiple regression analyses revealed that geographic location (i.e., urban, suburban, rural) influences mental health services utilization even when service availability and accessibility, socio-demographic and need factors are controlled. The results do not support the assumption that rural residence has uniformly negative effects on service use. Rural CSP clients, for example, were more likely to use crisis and supportive housing services than their urban counterparts. The findings suggest that models of service utilization must be carefully specified with regard to residential location.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Tax calculation will be finalised during checkout.
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
Tax calculation will be finalised during checkout.
Andersen, R. & Aday, L.A. (1978) Access to Medical Care in the U.S.: Realized and Potential.Medical Care, 16:533–546.
Andersen, R. & Newman, J. (1973) Societal and Individual Determinants of Medical Care Utilization in the United States.The Milbank Quarterly, 51:95–124.
Bachrach, L. (1982) The Process of Deinstitutionalization in Rural Areas. in P Keller and J.D. Murray (eds)Handbook of Rural Community Mental Health, New York: Human Sciences Press, pp 110–121.
Berry, B. & Davis, A. (1975) Community Mental Health Ideology: A Problematic Model for Rural Areas.American Journal of Orthopsychiatry, 48:673–679.
Cohen, J. (1972) The Effect of Distance On Use of Outpatient Services in a Rural Mental Health Center.Hospital and Community Psychiatry, 23:79–80.
Diehr, P., Williams, S., Martin, D., & Price, K. (1984) Ambulatory Mental Health Service Utilization in Three Provider Plans.Medical Care, 22:1–13.
Eaton, W. (1975) Residence, Social Class, and Schizophrenia.Journal of Health and Social Behavior, 15:289–299.
Edgerton, J.W. (1983) Models of Service Delivery. in A. Childs and G. Melton (eds)Rural Psychology, New York: Plenum Press, pp 275–303.
Goldstrom, I. & Manderscheid, R. (1982) The Chronically Mentally Ill: A Descriptive Analysis From the Uniform Client Data Instrument.Community Support Service Journal, 2:4–9.
Grusky, O., Tierney, K., Manderscheid, R., & Grusky, D. (1985) Social Bonding and Community Adjustment of Chronically Mentally Ill Adults.Journal of Health and Social Behavior 26:49–63.
Hollingsworth, R. & Hendrix, M. (1977) Community Mental Health in Rural Settings.Professional Psychology, 232–238.
Keatinge, C. (1987) Community Factors Influencing Psychiatric Hospital Utilization in Rural and Urban Ireland.Community Mental Health Journal, 23:192–203.
Leaf, P., Bruce, M., & Tischler, G. (1986) The Differential Effects of Attitudes on the Use of Mental Health Services.Social Psychiatry, 21:187–192.
Lopez, S. (1981) Mexican-American usage of Mental Health Facilities: Underutilization Considered. In A. Baron, Jr. (ed.)Explorations in Chicano Psychology, New York: Praeger.
Mueller, D. (1981) The Current Status of Urban-Rural Differences in Psychiatric Disorders: An Emerging Trend For Depression.Journal of Nervous and Mental Diseases, 169: 18–27.
O'Neil, J. (1977) Mental Health in Rural Areas.Exchange, 1:9–11.
Pratt, S., Giannitrapani, D., & Kahanna, P. (1960) Attitudes Towards the Mental Hospital and Selected Population Characteristics.Journal of Clinical Psychology, 16:214–218.
Pulakos, J. & Dengerink, H. (1983) comparison of Mental Health Services in Rural and Urban Washington.Community Mental Health Journal 19:164–172.
Robins, L., Helzer, J., Weissman, M., et al. (1984) Lifetime Prevalence of Specific Psychiatric Disorders in Three Cities.Archives of General Psychiatry, 41:949–958.
Sue, S., McKinney, H., Allen, D., & Hall, J. (1974) Delivery of Community Mental Health Services to Black and White Clients.Journal of Consulting and Clinical Psychology, 42:794–801.
Watts, C., Scheffler, R., & Jewell, N. (1986) Demand for Outpatient Mental Health Services in a Heavily Insured Population: The Case of Blue Cross and Blue Shield Association's Federal Employees Health Benefits Program.Health Services Research, 21:267–289.
Wells, K., Manning, W., Duan, N., Ware, J., & Newhouse, J. (1982)Cost and Cost Sharing for Ambulatory Mental Health Services. Rand, Santa Monica, CA DHHS Publication No. R2960-HHS.
Work on this paper was supported in part by a NIMH grant: # 5 T32 MH17120-04. A special thanks to Rick Tessler for his insightful comments on an earlier draft.
About this article
Cite this article
Sommers, I. Geographic location and mental health services utilization among the chronically mentally Ill. Community Ment Health J 25, 132–144 (1989). https://doi.org/10.1007/BF00755385
- Public Health
- Mental Health
- Regression Analysis
- Mental Health Service
- Geographic Location